What procedure do you use to deflate a Pulmonary Artery Catheter balloon?

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We have a debate going on in our unit relating to the correct deflation/locking procedure for Pulmonary Artery Catheter balloons. Historically we have always allowed the balloon to passively deflate after obtaining a wegde pressure. Once the pulmonary artery wedge pressure trace has reverted to a pulmonary artery trace we lock the syringe. Recently it has been suggested that this may not be an fail safe procedure as some air may remain in the balloon after passive deflation. A new method has been suggested which involves detaching the syringe from the gate valve while the gate is unlocked therefore allowing all the air in the balloon to escape via the gate valve. Once the trace has returned to a pulmonary artery waveform the gate can be locked and the syringe (with 1.5ml of air in it) reattached to the gate valve which should be locked to prevent inadvertant inflation of the balloon. We use the Edwards Lifescience Thermodilution VIP 834HF75 Catheter. What do you do in your unit?

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We wedge the balloon, get pawp recorded, slowly deflate balloon passivly, once fully deflated and no wedge tracing, lock stopcock, detatch syringe, expel the 1.5cc, reattach the syringe which is now empty to the closed off balloon port.

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We wedge the balloon, get pawp recorded, slowly deflate balloon passivly, once fully deflated and no wedge tracing, lock stopcock, detatch syringe, expel the 1.5cc, reattach the syringe which is now empty to the closed off balloon port.

This.

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Specializes in Cardiac.

1.5 cc air in, 1.5 cc air out... How can there be any residual air if the syringe passively fills back up to the 1.5 cc mark?

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